Northern Ireland NHS ‘simply unable to cope with the demands placed on it’: report
Northern Ireland's health system is unable to cope and will continue to struggle to meet demand, a report warns today.
Patients face unacceptable delays for treatment with a £160m-plus deficit across the sector. Key targets for inpatient and outpatient care are still not being achieved, even after expectations were lowered, the Northern Ireland Audit Office said.
Health trusts will struggle to reach future waiting time goals, it adds.
The warnings are set out in a report published today by Auditor General Kieran Donnelly.
He states: "It is clear from the results of my audit work that the health and social care system, as currently configured, is simply unable to cope with the demands being placed on it.
"Consequently, far too many patients endured unacceptably long waiting times for treatment."
Mr Donnelly calls for urgent reform and long term financial planning.
Health and social care funding is the single largest area of public expenditure in Northern Ireland.
In 2016/17 the total health budget was £4.9bn - 46% of the Executive's overall spend.
However, a rising population with people who are living longer and have more complex health needs, has led to unprecedented pressures.
Today's report covers the 2015/16 and 2016/17 period. A previous report looked at 2012/13 and 2013/14.
The Department of Health estimated that the underlying pressure across trusts at the start of 2017/18 was around £160m - up £45m from 2014/15.
The system has struggled to meet the increasing demand, leading to a surge in waiting times.
Across Northern Ireland as a whole, none of the waiting time targets examined by auditors for inpatient and outpatient care, accident and emergency treatment and cancer treatment were achieved in either 2015/16 or 2016/17.
Targets were routinely missed by trusts even though the goals for inpatient and outpatient care were lowered to take into account increased demands and pressures.
In 2014/15, 3,170 people waited over 12 hours for emergency care across Northern Ireland, but by 2016/17 this had grown to 6,494 - up 105%.
Auditors also raised concerns at the failure to meet key waiting time targets for cancer patients.
Mr Donnelly added: "Since we last reported, performance in respect of key waiting time targets has clearly been very disappointing.
"Going forward, I can only conclude that the rising demand for services which is increasingly exceeding health service capacity, together with ongoing uncertainty over future funding, will significantly impact on the ability of Health and Social Care Trusts to meet future population needs."
In recent years, trusts have been allocated funding for extra evening and weekend clinics to reduce waiting lists, known as the Waiting List Initiative (WLI) activity. However, a review of WLI payments made by the Southern Trust from April 2015 to March 2016 identified that the trust had entered into an agreement with consultants based on the number of cases the trust expected to be completed during four hour in-house sessions.
While consultants delivered all work allocated to them, some completed the cases in less than the allocated four hours.
For those consultants, the Southern Trust paid almost £247,000 which had no impact on reducing waiting lists.